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L3978 Medicaid reimbursement rates by state

Shoulder elbow wrist hand finger orthosis. 36 state Medicaid programs publish a fee-for-service rate for L3978 at the physician psychologist level. Rates run from $100.00 in Connecticut to $2,242.98 in Montana, with a median of $1,727.26.

Data as of 2026-10-05. Every rate links to the official document it came from.

States publishing
36
Median rate
$1,727.26units vary by state
Highest
$2,242.98Montana
Medicare (non-facility)
—not on the physician fee schedule

L3978 rate in every state

One like-for-like fee-for-service rate per state, highest first. Units can differ between states; the per-hour column converts time-based units.

StateMedicaid rateUnitPer hourManaged-care plans% of MedicareSource
MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service)$2,242.98since 2026-01-01——Not classified—Montana Healthcare Programs fee schedule
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$2,218.63since 2026-01-01——Plans negotiate; applies out of network—MHCP Fee Schedule - Current Fee Schedule
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$2,186.77since 2025-01-01——Plans must pay at least this—New Mexico Medicaid Fee for Service HCPC
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$2,175.13since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
MaineAny qualified provider (rate does not vary by provider) · MaineCare (fee-for-service)$2,165.46since 2026-01-01——Not classified—MaineCare Section 60, Medical Supplies a
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$1,948.91since 2026-01-01Each—Plans must pay at least this—DMAS procedure fee file hcpcmedical.csv
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$1,899.46since 2026-07-01——Plans negotiate; applies out of network—Rates for Prostheses, Prosthetic Devices
NebraskaAny qualified provider (rate does not vary by provider) · Nebraska Medicaid (fee-for-service)$1,895.64since 2026-07-01——Plans negotiate; applies out of network—Nebraska Medicaid fee schedule 471-000-5
IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell)$1,870.95since 2026-07-01——Not classified—Idaho Medicaid Numerical Fee Schedule Ju
New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS)$1,865.92since 2024-07-01——Not classified—2026 Fee Schedule - Covered Procedures R
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$1,840.64since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA)$1,815.17since 2026-01-01——Not classified—Vermont Medicaid Fee Schedule - DME Code
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$1,814.25since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service)$1,802.16since 2024-07-01——Not classified—SCDHHS Durable Medical Equipment (DME) F
MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service)$1,784.53since 2026-07-01——Plans must pay at least this—DOM Comprehensive Fee Schedule, Septembe
KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule)$1,766.19since 2026-07-01——Paid by the state, outside plans—KMAP Fee Schedule MKN Medicaid (FeeSched
West VirginiaAny qualified provider (rate does not vary by provider) · West Virginia Medicaid (fee-for-service, Bureau for Medical Services)$1,732.37since 2026-04-01——Plans must pay at least this—BMS DME 2026 Rural Fee Schedule Effectiv
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$1,731.18since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$1,723.33since 2025-06-04——Not classified—Arkansas Medicaid Prosthetics (includes
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$1,698.40since 2026-01-01——Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules)$1,679.78since 2017-01-01——Plans negotiate; applies out of network—Provider Type 33, Durable Medical Equipm
OregonAny qualified provider (rate does not vary by provider) · Oregon Health Plan (fee-for-service, OHA)$1,658.59since 2024-10-01——Plans negotiate; applies out of network—OHP FFS medical-dental fee schedule (fee
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$1,627.50since 2021-07-01——Plans negotiate; applies out of network—HCA Prosthetics and orthotics fee schedu
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$1,605.19since 2026-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service)$1,595.98since 2019-07-01——Plans negotiate; applies out of network—MO HealthNet fee schedule: Durable Medic
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$1,561.36since 2026-01-01——Plans must pay at least this—SoonerCare Durable Medical Equipment Rat
New YorkAny qualified provider (rate does not vary by provider) · New York Medicaid (fee-for-service)$1,534.67since 2022-06-01——Plans negotiate; applies out of network—eMedNY NYS Medicaid DMEPOS Fee Schedule
New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service)$1,515.82since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service)$1,448.04——Plans negotiate; applies out of network—NC Medicaid fee schedule 'Orthotics and
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$1,433.96since 2020-01-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Durable
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$1,219.26since 2016-07-01——Plans negotiate; applies out of network—Orthotic and Prosthetic Fee Schedule - E
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$1,169.00since 2026-05-27——Not classified—DME/POP Fee Schedule (REF-0132-Q)
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$1,134.82since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$1,093.39since 2026-03-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Ortho
IowaPhysician or licensed psychologist (incl. BCBA-D) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$610.01since 2018-09-01——Plans must pay at least this—Iowa Medicaid fee schedule #02 PHYSICIAN
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$100.00since 2017-03-01——Not classified—CMAP fee schedule: 10/01/2026 MEDS - Pro

Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices with the CMS formula; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Frequently asked questions

What does Medicaid pay for L3978?

It depends on the state. Of the 36 states with a published fee-for-service rate, the median is $1,727.26. Montana pays the most ($2,242.98) and Connecticut the least ($100.00).

Which state pays the highest Medicaid rate for L3978?

Montana, at $2,242.98, effective 2026-01-01.

Do managed-care plans pay the same rate for L3978?

Not necessarily. Each state's plan contracts decide whether plans must pay at least the fee-for-service rate, pay a state-set rate, or negotiate their own. The table shows the rule for each state, cited to the contract or statute.

Related Equipment & supplies codes

A7000Canister, disposable, used with suction pump, each · 42 statesA8001Helmet, protective, hard, prefabricated · 42 statesB9002Enteral nutrition infusion pump, any type · 42 statesE0105Cane, quad or three prong, includes canes of all materials · 42 statesE0130Walker, rigid (pickup), adjustable or fixed height · 42 statesE0135Walker, folding (pickup), adjustable or fixed height · 42 statesE0143Walker, folding, wheeled, adjustable or fixed height · 42 statesE0149Walker, heavy duty, wheeled, rigid or folding, any type · 42 statesE0163Commode chair, mobile or stationary, with fixed arms · 42 statesE0185Gel or gel-like pressure pad for mattress · 42 statesE0271Mattress, innerspring · 42 statesE0470Respiratory assist device, bi-level pressure capability · 42 states
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